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lANCET: Management of autism in France: “a huge job to be done” [psychoanalysis]

Messages
13,774
Currently open access, but not sure how long this will be the case: http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(14)70290-1/fulltext

Despite the Ministry of Health's revised treatment plan, France recently faced criticism by the Council of Europe for its discrimination against those with autism. Some rights groups are calling the state of autism treatment in France a “scandal” and claim the government's plan doesn't go far enough. Others say the continued use of psychoanalysis to treat autism is keeping France from advancing.

Elodie Nourrisson, from the suburbs of Paris, first got answers about her son Thomas's behaviour when he was 26 months old. Since birth, he did not move or cry much, had difficulties walking, and was not troubled when separated from his parents. Lately, he had become hyperactive and was not sleeping more than 2 h per night. A doctor from one of the French public sector's Medico-psycho-pedagogical centres (CMPP) said that Thomas simply had developmental delays. “At the beginning, we felt reassured”, says Nourrisson. “[The doctor said] there was a significant overall retardation but that they could help him.”

Waiting lists, ineffective treatments, and frustration ensued for Nourrisson. It was not until she went to a private specialist, when Thomas was nearly 3 years old, that she finally heard the word “autism” in reference to her son.

Since the beginning, Nourrisson says she has been left by the public health system to “manage things on her own”. M'Hammed Sajidi, the president of the autism rights organisation Conquer Autism, says this scenario is all too familiar for families of the estimated one in 68 children with autism in France. “It's an absolute outrage”, says Sajidi, whose own son has autism. “France is the most delayed country in Europe when it comes to autism treatment.” According to Sajidi, medical professionals and teachers do not receive enough specialised training to treat autism, the government funds ineffective treatment methods—such as psychoanalysis—and families are often left to their own devices to treat their children.

Bonnet-Brilhault says each programme must be individually tailored to the child, and thus does not favour one method over another. The centre incorporates methods such as TEACH—a therapeutic tool that helps people with autism understand and navigate their surroundings—and applied behaviour analysis (ABA), which applies behavioural principles to everyday situations to increase or decrease some behaviours. She is not entirely opposed to the use of psychoanalysis to help families if it is part of an integrated plan, but not in the way it has been used in the past. “Blaming the mother for autism? That's finished”, says Bonnet-Brilhault. “We can no longer continue with this idea. Making the mother responsible is ignoring all the medical knowledge we have now. Parents need to be informed and accompanied, not put at the root of autism.”

As part of the HAS's 2012 autism recommendations, psychoanalysis is not recommended as an exclusive treatment method for people with autism. “We established that we don't have enough data on its effectiveness. And since there's a divergence between families and professionals—and among professionals themselves—no conclusion could have been drawn.” says HAS project leader Joelle André-Vert.

Still, psychoanalysis that is performed by a psychiatrist within the public sector is included in the national health coverage. And despite calls from the HAS and the health ministry to favour new methods like TEACH or ABA, it has been slow to take.

Nourrisson was told to begin psychoanalysis when her son Thomas was first diagnosed with developmental delays. Thomas was put on a waiting list at the CMPP while Nourrisson was told to meet with a child psychiatrist for psychoanalytic sessions. “The psychiatrist would ask me questions about my relationship with my mother and about my pregnancy”, says Nourrisson. “I was shamed in several sessions by the psychoanalyst…I would walk out in tears, while Thomas was left unattended and causing a ruckus.”

One Paris-based psychiatrist has been outspoken in his support for psychoanalysis to treat the early stages of autism. Charles Melman is the co-founder of the Association Lacanienne Internationale, which follows the principles of Freud and Lacan. He says, “it's not a question of blaming mothers, but allowing them to live their parenthood in a better way”. Melman says there is “no proof” that autism has genetic origins but instead results from a mother's emotional state or behaviour during pregnancy or in early parenthood. “[Autism] stems from a mother's incapacity to take her child's birth as a joyous occasion”, says Melman. He recently treated one woman whose son was diagnosed with autism at 6 months, using psychoanalysis with the mother and psychotherapy sessions for the child. He says that the child, now 18 months, no longer needs therapy.
Melman says that early detection is key, and that if children with autism receive therapeutic treatment between 3 months and 2·5 years, they can recover completely and return to “normal”. Detection of autism in France is happening too late, says Melman, whose organisation lodged an appeal against the government's Third Autism Plan.

Melman and fellow psychoanalysts—who traditionally wield great power in France when it comes to the treatment of mental illness—have been met with heated criticism in the face of the autism debate. But although opinions differ on the use of psychoanalysis, early detection and diagnosis is deemed essential by both sides. Child psychiatrist Deborah Cohen, who specialises in the treatment of children with autism, says giving a diagnosis is essential. “It allows for the child to receive the appropriate treatment and if it's an early diagnosis, it allows for a better understanding of the person and his specific needs”.
Hope the quacks are held accountable, but pretty sure they won't be.
 

A.B.

Senior Member
Messages
3,780
This is a documentary about French psychoanalysts who think they can treat autism (English subtitles are available):


They're totally nuts as you will see.

This documentary was banned in France until six months ago by the way. The psychoanalysts didn't want anyone to see it, and convinced a judge to ban it with a flimsy excuse.
 
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chipmunk1

Senior Member
Messages
765
She is not entirely opposed to the use of psychoanalysis to help families if it is part of an integrated plan, but not in the way it has been used in the past. “Blaming the mother for autism?

didn't know that french psychology plays the Blame Game as well.

Well who doesn't? it's just that they like using different names for it. Some call it "Analysis" and others call it "CBT".

This is a documentary about French psychoanalysts who think they can treat autism (English subtitles are available):

when will we see a documentary where they show CBT therapists thinking they can treat ME?
 
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Cheshire

Senior Member
Messages
1,129
Yes, I sometimes feel very ashamed of being French... These psychoanalysts are really insane, specially the Lacan followers. (Jacques Lacan used to say that psychoanalysis is a delirium, which he was very proud of...). One cannot imagine to what point their speech is meaningless.

They are losing their influence (very slowly) in adults’ psychiatry and psychotherapy. But for lots of people here psychiatry = psychoanalysis.

But they are still incredibly influent in children psychiatry. Saying disgusting things like, "the subject chooses autism".

But one thing that comforted me when I became ill, is that I knew to what extend a whole body of professionals can be wrong against all evidence. And the example of the parents of autistic children fighting against the psychoanalytic lobby has always been in my mind.

These psychiatrists can't cancel their theory, they have built up their own career, their own professional identity upon it. They can't admit that autism is not a psychosis, because they have been too deeply into it.

Melman says there is “no proof” that autism has genetic origins but instead results from a mother's emotional state or behaviour during pregnancy or in early parenthood.

Denial against so much evidence. I think lots of BPS model of CFS supporters will claim CFS to be psychosomatic against the evidence a long time, the most intelligent or opportunist will discreetly change their position.
 
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chipmunk1

Senior Member
Messages
765
These psychiatrists can't cancel their theory, they have built up their own career, their own profesional identity upon it. They can't admit that autism is not a psychosis, because they have been too deeply into it.

maybe one should propose the hypothesis that psychoanalysis is a psychosis?
 

barbc56

Senior Member
Messages
3,657
Melman says there is “no proof” that autism has genetic origins but instead results from a mother's emotional state or behaviour during pregnancy or in early parenthood. “[Autism] stems from a mother's incapacity to take her child's birth as a joyous occasion

I'm speechless! The concept of "refrigerator mothers" has long passed or so I thought.

Thanks @Esther12 for the article.

Barb
 

shahida

Senior Member
Messages
120
This is so interesting. Im interested in how ME is regarded around the world and looked up ME/CFS in France and there doesn't seem to be much out there in terms of support groups etc. giving me the impression that the psychos have greater cultural influence there. Are there any national ME groups in France?
 

Cheshire

Senior Member
Messages
1,129
This is so interesting. Im interested in how ME is regarded around the world and looked up ME/CFS in France and there doesn't seem to be much out there in terms of support groups etc. giving me the impression that the psychos have greater cultural influence there. Are there any national ME groups in France?

There’s a group called l’Association Française du Syndrome de Fatigue Chronique.

There are several points that are really problematic.

- You can’t access their documentation unless you’re a member. To me it’s unacceptable. The aim of such a group should be to spread the information.

- It’s supposed to be a support group for sufferers, but in fact it’s its “scientific” board which is leading the agenda. The only requirement of the director seems to be that they don’t say it’s a psychiatric condition. But they can claim it’s functional, somatoform, that the best way to manage it is GET and CBT, that the illness is perpetuated by negative thoughts and maladaptive behaviors. They didn’t use the P word, so no problem.

- In their last bulletin, Pr Cabane said:

Un consensus français n’est pas envisageable dans l’immédiat, faute de moyens. Cela n’empêche pas le Conseil Scientifique de se pencher sur l’élaboration d’un texte destiné à être publié avec des experts français qui travaillerons sans conflit d’intérêt, sans directive ni pression, en toute indépendance, par opposition au consensus canadien, soumis à la pression de certains lobbies.
http://www.asso-sfc.org/documents/an-190-Bulletin-N34--Juin-2014-.pdf (i don't know why this bulletin is free access)


which could be translated that way :

"A French consensus is not possible now because of lack of resources. This does not prevent the Scientific Council to consider development of a text to be published with French experts who work without conflict of interest, without direction or pressure, independently, as opposed to the Canadian consensus subject to pressure from certain lobbies."


No comment needed… :aghhh:
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
One Paris-based psychiatrist has been outspoken in his support for psychoanalysis to treat the early stages of autism. Charles Melman is the co-founder of the Association Lacanienne Internationale, which follows the principles of Freud and Lacan. He says, “it's not a question of blaming mothers, but allowing them to live their parenthood in a better way”.

Melman says there is “no proof” that autism has genetic origins but instead results from a mother's emotional state or behaviour during pregnancy or in early parenthood. “[Autism] stems from a mother's incapacity to take her child's birth as a joyous occasion”, says Melman.

He recently treated one woman whose son was diagnosed with autism at 6 months, using psychoanalysis with the mother and psychotherapy sessions for the child. He says that the child, now 18 months, no longer needs therapy.

Melman says that early detection is key, and that if children with autism receive therapeutic treatment between 3 months and 2·5 years, they can recover completely and return to “normal”.

ummm so in otherwise he wrongly diagnosed a 6mth old with autism who recovered cause the child didnt have autism after all. Diagnosing 3mth olds!! what! How does one diagnose a 3mth old with autism? (babies cant even focus their eyes properly at first). I guess this all plays into his I can treat that child cause its the mothers fault thing well .. (due to the false diagnoses)
 

shahida

Senior Member
Messages
120
There’s a group called l’Association Française du Syndrome de Fatigue Chronique.

There are several points that are really problematic.

- You can’t access their documentation unless you’re a member. To me it’s unacceptable. The aim of such a group should be to spread the information.

- It’s supposed to be a support group for sufferers, but in fact it’s its “scientific” board which is leading the agenda. The only requirement of the director seems to be that they don’t say it’s a psychiatric condition. But they can claim it’s functional, somatoform, that the best way to manage it is GET and CBT, that the illness is perpetuated by negative thoughts and maladaptive behaviors. They didn’t use the P word, so no problem.

- In their last bulletin, Pr Cabane said:


http://www.asso-sfc.org/documents/an-190-Bulletin-N34--Juin-2014-.pdf (i don't know why this bulletin is free access)


which could be translated that way :

"A French consensus is not possible now because of lack of resources. This does not prevent the Scientific Council to consider development of a text to be published with French experts who work without conflict of interest, without direction or pressure, independently, as opposed to the Canadian consensus subject to pressure from certain lobbies."


No comment needed… :aghhh:
It's hard to believe that things are even worse in other places- what one earth does your average person with ME in France do? At least in the UK there are organisations and charities which support sufferers- I suppose you can join these internationally even though you're in France.
If I ever got better I'd love to improve my basic French.
 

Cheshire

Senior Member
Messages
1,129
A little update to the situation of autism in France, as this situation bears so many similarities with how MECFS is handled worldwide.


As it's the international day of autism today, there have been a lot of TV and radio shows, and a film on a public channel, talking about the difficulties a couple encountered to have their son diagnosed, how the medical professionals have been brutal and violent, blaming them for their son's problems.


And for the first time since France officially recognised autism as a neurodevelopmental disorder in the 2000's, there was not a single psychoanalyst invited anywhere. Before, there was always one, "to present both sides of the debate". The film has been a success. There was a national backlash of psychoanalysis. Unbelievable. Seems like the battle to convince the media and the public is won.


BUT despite the government clearly stating that psychoanalysis should have nothing to do with autism:

- out of 130 universities teaching psychology, only 5 have banned psychoanalysis from their teaching. So a whole generation is still fed with these insane theories.

- the staff in the centres dedicated to autism are still overwhelmingly intoxicated with Freudian theories.

- the psychoanalysis lobby has still a declining but nonetheless important influence.


I don't know how long it will take for France to put all that rubbish into the dustbin it deserves to be... But sadly even when the majority (government, public, media, neuroscientific community) is appalled by the Freudian management of autism, the so-called experts are still in place (one factor being that if you fired everyone, there would be nearly anybody to take care of autistic children...)


I'm thinking of the UK and I'm afraid the cleaning will take time. And maybe it's better to have no official diagnosis of ME here in France, because in a few years (or months?
clip_image001.png
) there will be no need to wipe the room, we'll start from scratches.
 
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chipmunk1

Senior Member
Messages
765
- out of 130 universities teaching psychology, only 5 have banned psychoanalysis from their teaching. So a whole generation is still fed with these insane theories.

if they wouldn't use psychoanlysis they would use behaviourism which is a bit better but not so much and it's still insane. So as it stands now the insanity can only be replaced with another insanity.

http://www.forbes.com/sites/emilywi...apy-is-torture-says-un-official/#2e5330744fc2

http://www.dailymail.co.uk/news/art...-education-center-electric-shock-therapy.html
 

Cheshire

Senior Member
Messages
1,129
if they wouldn't use psychoanlysis they would use behaviourism which is a bit better but not so much and it's still insane. So as it stands now the insanity can only be replaced with another insanity.

http://www.forbes.com/sites/emilywi...apy-is-torture-says-un-official/#2e5330744fc2

http://www.dailymail.co.uk/news/art...-education-center-electric-shock-therapy.html

For kids with autism psychoanalysis is completely destructive, it says it's a psychosis caused by problems in the mother-children interaction, being the fault of the mother. It's bad science. Behavioral techniques, if used without ideology, are way better. They acknoledge the biological nature of the disorder and don't try to put the blame on anyone (theoretically, I'm sure if children don't improve, a few AH will say it's the parent's fault) But even if they're not magical, if behavioral techniques have been oversold and great promises have been made to parents, (yes your son will talk, he will interact, these techniques are wonderfull...), it's better than Freudian theories.
 

chipmunk1

Senior Member
Messages
765
They do accept that biology plays a role but that doesn't mean that psychotherapy can't fix biology!

Professor Simon Baron-Cohen, a psychologist at Cambridge University and one of Britain’s leading experts on the condition, said recently: ‘People with autism are just like anyone else and can be capable of learning.
‘This can change the nature of their brains — because when any child learns, this process must make changes in their brain.’

http://www.dailymail.co.uk/health/a...haviour-transformed-So-experts-sceptical.html
 

barbc56

Senior Member
Messages
3,657
And for the first time since France officially recognised autism as a neurodevelopmental disorder in the 2000's, there was not a single psychoanalyst invited anywhere. Before, there was always one, "to present both sides of the debate". The film has been a success. There was a national backlash of psychoanalysis. Unbelievable. Seems like the battle to convince the media and the public is won

That's encouraging news.

The psychoanalytic school of thought came up with "refrigerator mothers". Blech! It's shameful that these poor mothers were blamed for their child's physical condition and the guilt placed upon them.because of this.

That was a long time ago and things have changed but it's appalling that it wasn't until this year that this happened at all,

Thanks for this post. It was certainly eye opening.

ETA Somehow I missed the rest of the thread. I didn't realize I had posted. :bang-head:

Still worth repeating.:rolleyes:
 
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Messages
724
Location
Yorkshire, England
http://masondixonautistic.blogspot.co.uk/2013/11/challenging-behaviourists.html

From the viewpoint of a man with autism.

The work and legacy of Ivor Lovaas is not addressed at all, but he's the dirty skeleton in the behaviourist closet. The most successful study of ABA in Autism comes from his landmark 1987 paper and the results of this have never been replicated. They can't be replicated either because this study relied extensively on the use of punishments, but to describe it as 'punishment' puts it quite mildly. At the University of California and Berkely, Lovaas doused children in icy water, made them stand in uncomfortable positions, starved them, slapped them, blew loud noises directly into their ears, pinched them, pulled their hair, slammed them down and made them walk barefoot on an electrified floor. He tortured them.

Where they can get away with it; they do it. It makes their sentiments about 'nice ABA' utterly empty and where they are genuine in their sentiments- they do not get to choose what ABA is about. They can only choose whether they do it or don't do it; the consequences are what gets the final word, yet there is no qualitative research into adult outcomes for children who have received ABA. In fact there is very little qualitative research at all, despite it being the responsibility of research behaviourists to produce it.
(emphasis added)